Oncology Commons^™

“Talk To Me:” A Mixed Methods Study On Seriously Ill Patients’ Views On Physician Behaviours During Advance Care Planning And End-Of-Life Communication, Amane Abdul-Razzak

Open Access Dissertations and Theses

Background: The objective of this mixed methods study is to understand, from the perspectives of seriously ill hospitalized patients, the effect of modifiable physician behaviours on the perceived quality of end-of-life and ACP communication.

Methods: A convergent parallel mixed methods design is used. Participants were recruited from inpatient medical wards at two academic hospitals, and a population with a high risk of mortality at 6-12 months was selected. In the quantitative strand, a questionnaire was administered to measure patients’ self-rated satisfaction with their physician’s ACP communication skills. The primary analysis involved calculation of the strength of correlation between individual ...

Evaluating The Utility Of Clinical Criteria For The Identification Of Lynch Syndrome Among Endometrial Cancer Patients, Amanda S. Bruegl

UT GSBS Dissertations and Theses (Open Access)

Background: Lynch Syndrome (LS) is a familial cancer syndrome with a high prevalence of colorectal and endometrial carcinomas among affected family members. Clinical criteria, developed from information obtained from familial colorectal cancer registries, have been generated to identify individuals at elevated risk for having LS. In 2007, the Society of Gynecologic Oncology (SGO) codified criteria to assist in identifying women presenting with gynecologic cancers at elevated risk for having LS. These criteria have not been validated in a population-based setting.

Materials and Methods: We retrospectively identified 412, unselected endometrial cancer cases. Clinical and pathologic information were obtained from the electronic ...

Body Talk I: Habituation To Bodily Changes After Breast Surgery In Women, Jenny Slatman

Future Directions in Feminist Phenomenology

No abstract provided.

Sp526-A Do You Know How To Lower Your Risk For Cancer?, Bobbi P. Clarke

Health, and Fitness

No abstract provided.

Characterization Of Differentiation And Prognostic Biomarkers On Cd8+ Tumor-Infiltrating Lymphocytes In Metastatic Melanoma, Richard C. Wu

UT GSBS Dissertations and Theses (Open Access)

CD8⁺ cytotoxic T lymphocytes (CTL) frequently infiltrate tumors, yet most melanoma patients fail to undergo tumor regression. We studied the differentiation of the CD8⁺ tumor-infiltrating lymphocytes (TIL) from 44 metastatic melanoma patients using known T-cell differentiation markers. We also compared CD8⁺ TIL against the T cells from matched melanoma patients’ peripheral blood. We discovered a novel subset of CD8⁺ TIL co-expressing early-differentiation markers, CD27, CD28, and a late/senescent CTL differentiation marker, CD57. This CD8⁺CD57⁺ TIL expressed a cytolytic enzyme, granzyme B (GB), yet did not express another cytolytic pore-forming molecule, perforin (Perf). In contrast, the CD8⁺CD57⁺ T ...

Novel Therapeutic Targets Identified By High-Throughput Technologies For Triple-Negative Breast Cancer, Christine Shiang

UT GSBS Dissertations and Theses (Open Access)

Triple-negative breast cancers (TNBC) are characterized by the lack of or reduced expression of the estrogen and progesterone receptors, and normal expression of the human epidermal growth factor receptor 2. The lack of a well-characterized target for treatment leaves only systemic chemotherapy as the mainstay of treatment. Approximately 60-70% of patients are chemosensitive, while the remaining majority does not respond. Targeted therapies that take advantage of the unique molecular perturbations found in triple-negative breast cancer are needed. The genes that are frequently amplified or overexpressed represent potential therapeutic targets for triple-negative breast cancer. The purpose of this study was to ...

Targeted Sirna Delivery Methods For Rnai-Based Therapies, Di Chen

University of Western Ontario - Electronic Thesis and Dissertation Repository

RNAi has great potential in future therapeutics as it has the ability to regulating many disease-related genes. However, many barriers prevent practical applications. To overcome the barriers, the specific targeting, efficient delivery system, the validated gene and the potent siRNA sequence are all vital important. The studies throughout this thesis have been focued on examining the validation of three RNAi therapies for two different disease models: allergic contact dermatitis and melanoma. For allergic contact dermatitis, I developed and tested a novel topical delivery system for siRNAs targeting TNFα (siTNFα) and MyD88 siRNA (siMyD88). While siRNAs applied without the transdermal enhancer ...

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based ...

Slow-Cycling Therapy-Resistant Cancer Cells, Nathan F. Moore, Jeanmarie Houghton, Stephen Lyle

GSBS Student Publications

Tumor recurrence after chemotherapy is a major cause of patient morbidity and mortality. Recurrences are thought to be secondary to small subsets of cancer cells that are better able to survive traditional forms of chemotherapy and thus drive tumor regrowth. The ability to isolate and better characterize these therapy-resistant cells is critical for the future development of targeted therapies aimed at achieving more robust and long-lasting responses. Using a novel application for the proliferation marker carboxyfluorescein diacetate, succinimidyl ester (CFSE), we have identified a population of slow-cycling, label-retaining tumor cells in both in vitro sphere cultures and in vivo xenograft ...

Imatinib Reverses Doxorubicin Resistance By Affecting Activation Of Stat3-Dependent Nf-Κb And Hsp27/P38/Akt Pathways And By Inhibiting Abcb1, Jonathan T. Sims, Sourik S. Ganguly, Holly Bennett, J. Woodrow Friend, Jessica Tepe, Rina Plattner

Molecular and Biomedical Pharmacology Faculty Publications

Despite advances in cancer detection and prevention, a diagnosis of metastatic disease remains a death sentence due to the fact that many cancers are either resistant to chemotherapy (conventional or targeted) or develop resistance during treatment, and residual chemoresistant cells are highly metastatic. Metastatic cancer cells resist the effects of chemotherapeutic agents by upregulating drug transporters, which efflux the drugs, and by activating proliferation and survival signaling pathways. Previously, we found that c-Abl and Arg non-receptor tyrosine kinases are activated in breast cancer, melanoma, and glioblastoma cells, and promote cancer progression. In this report, we demonstrate that the c-Abl/Arg ...

The Face Of Cancer In Montgomery County Ohio: A Look At The Population At Risk, Chika E. Okere

Master of Public Health Program Student Publications

The purpose of this study was to identify the population in Montgomery County Ohio who are at the greatest risk for cancer based on age, sex, and race/ethnicity, family history and demographics. The research will also look at modifiable behaviors such as use of tobacco products, physical inactivity, obesity, poor nutrition and heavy drinking of alcohol that increase the risk and identify areas of improvement in data collection for reporting purposes. During 1996-2006, cancer was the second-leading cause of death for residents of Montgomery County.

Methods: Age, sex, race/ethnicity of people in Montgomery County with cancer were examined ...

Identifying The Health And Supportive Care Needs Of Adolescent And Young Adult Survivors Diagnosed With Cancer: A Mixed Methods Study, Elena Tsangaris

Open Access Dissertations and Theses

Purpose: Current cancer programs in Canada manage adolescents (15-18 years) under a pediatric model of care, and young adults (19-25 years) under a disease-centered model of care. Key issues arise because neither of these models adequately meets the needs of adolescents and young adults (AYA). The aim of this study is to identify health and supportive care (HSC) needs of AYA survivors with cancer. Method: A concurrent nested mixed-method design was employed. Qualitative description and a systematic literature review (SLR) were used. Medline, Cochrane Central, PubMed, PsycInfo CINAHL and EMBASE were searched from their date of inception to October 2011 ...

Early Results Of Prostate Cancer Radiation Therapy: An Analysis With Emphasis On Research Strategies To Improve Treatment Delivery And Outcomes., Kosj Yamoah, Kwamena Beecham, Sarah E Hegarty, Terry Hyslop, Timothy Showalter, Joel Yarney

Department of Radiation Oncology Faculty Papers

ABSTRACT: BACKGROUND: There is scant data regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT). METHODS: A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy, Ghana from 2003 to 2009. Data were collected regarding patient-and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score (GS), clinical stage (T), and use of androgen deprivation therapy (ADT). For patients who received EBRT, freedom from biochemical failure (FFbF ...

Formative Development Of A Culturally Appropriate Mammography Screening Campaign For Low-Income African-American Women., Kimberly D. Leeks, Ingrid J. Hall, C. Ashani Johnson-Turbes, Ngozi Kamalu, Yasmine Zavahir

Journal of Health Disparities Research and Practice

The purpose of this qualitative study was to conduct a formative evaluation of messages and materials to inform the development of a promotional, health campaign designed to increase breast cancer screening awareness and utilization among low-income, uninsured African American women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Savannah and Macon, Georgia (GA). A priority of CDC is to understand why women eligible for screening through the NBCCEDP do not participate in NBCCEDP screening services as well as to identify effective strategies for increasing enrollment among NBCCEDP-eligible women who have never received breast cancer screening. As ...

A 2-Step Approach To Myeloablative Haploidentical Stem Cell Transplantation With Optimized T-Cell Dosing: Early Immune Reconstitution Leads To Better Outcomes, Sameh Gaballa, Onder Alpdogan, Matthew Carabasi, Joanne Filicko, Margaret Kasner, Ubaldo E. Martinez-Outshoorn, Md, John L Wagner, Mark Weiss, Neal Flomenberg, Delores Grosso

Department of Medical Oncology Faculty Papers

We developed a 2-step approach to myeloablative haploidentical HSCT in which patients receive a large fixed dose of cyclophosphamide (CY)-tolerized T cells separately frm the HSC infusion in the hopes of accelerating post HSCT immune reconstitution (IR). The uniformity of the T cell dosing facilitates comparison of patients without (low risk) and with (high risk) active malignancy at HSCT to ascertain the impact of disease status at HSCT on IR with fewer confounding effects from conditioning or T cell dosing.

The Use Of Infliximab To Control Recurrent Cytokine Storms In Ebv-Associated Angioimmunoblastic Lymphoma And Hemophagocytic Syndrome, Sameh Gaballa, Emmanuel Besa, Onder Alpdogan

Department of Medical Oncology Faculty Papers

Introduction: Chronic active Epstein-Barr virus infection (CAEBV) has been implicated in several diseases including hemophagocytic lymphohistiocytosis (EBV-HLH) and lymphomas including Angioimmunoblastic T cell lymphoma. The exact mechanism by which EBV infection causes these complications is currently not well understood. EBV-HLH is a syndrome in which T-cells, NK cells and macrophages are aberrantly activated. Cytokine storms play a major role in cellular damage and organ dysfunction. In the event that the body is unable to clear the EBV viremia, dysregulated T, NK cells and macrophages continue to release cytokines leading to the accumulation of lymphohistiocytic infiltrates into organs and organ damage ...

Sickle Cell Pain: A Critical Reappraisal., Samir K. Ballas, Kalpna Gupta, Patricia Adams-Graves

Department of Medicine Faculty Papers

Sickle cell pain includes 3 types: acute recurrent painful crises, chronic pain syndromes, and neuropathic pain. The acute painful crisis is the hallmark of the disease and the most common cause of hospitalization and treatment in the emergency department. It evolves through 4 phases: prodromal, initial, established, and resolving. Each acute painful episode is associated with inflammation that worsens with recurrent episodes, often culminating in serious complications and organ damage, such as acute chest syndrome, multiorgan failure, and sudden death. Three pathophysiologic events operate in unison during the prodromal phase of the crisis: vaso-occlusion, inflammation, and nociception. Aborting the acute ...

Phase Ii Evaluation Of Dasatinib In The Treatment Of Recurrent Or Persistent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study., Russell J Schilder, William E Brady, Heather A Lankes, James V Fiorica, Mark S Shahin, Xun C Zhou, Robert S Mannel, Harsh B Pathak, Wei Hu, R Katherine Alpaugh, Anil K Sood, Andrew K Godwin

Department of Medical Oncology Faculty Papers

OBJECTIVES: Preclinical data suggest an important role for the sarcoma proto-oncogene tyrosine kinase (SRC) in the oncogenesis of epithelial ovarian cancer (EOC) or primary peritoneal carcinoma (PPC). The Gynecologic Oncology Group (GOG) conducted a Phase II trial to evaluate the efficacy and safety of dasatinib, an oral SRC-family inhibitor in EOC/PPC, and explored biomarkers for possible association with clinical outcome.

METHODS: Eligible women had measurable, recurrent or persistent EOC/PPC and had received one or two prior regimens which must have contained a platinum and a taxane. Patients were treated with 100mg orally daily of dasatinib continuously until progression ...

Epidemiology And The Cancer Problem, Shakeeb Yunus

Cancer Concepts Textbook

Epidemiology is the study of populations using defined research methods to confirm the patterns and causes of disease and applying this information to improve the health of the populations. This branch of science is the basis for understanding the spread of diseases in a defined area or group of people. Epidemiologic studies have been instrumental in improving outcomes by establishing preventive and therapeutic measures for the incidence, prevalence and mortality from cancers. The incidence of malignancy in a country or in our world defines the magnitude of the cancer problem. This chapter in the Cancer Concepts textbook will introduce the ...

Fibulin-2 Stabilizes Tumor Extracellular Matrix And Drives Malignant Progression Of Lung Adenocarcinoma, Brandi N. Baird

UT GSBS Dissertations and Theses (Open Access)

The ECM of epithelial carcinomas undergoes structural remodeling during periods of uncontrolled growth, creating regional heterogeneity and torsional stress. How tumors maintain ECM integrity in the face of dynamic biophysical forces is still largely unclear. This study addresses these deficiencies using mouse models of human lung adenocarcinoma. Spontaneous lung tumors were marked by disorganized basement membranes, dense collagen networks, and increased tissue stiffness. Metastasis-prone lung adenocarcinoma cells secreted fibulin-2 (Fbln2), a matrix glycoprotein involved in ECM supra-molecular assembly. Fibulin-2 depletion in tumor cells decreased the intra-tumoral abundance of matrix metalloproteinases and reduced collagen cross-linking and tumor compressive properties resulting in ...